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Therapeutic ultrasound

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https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#1
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#2
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29212476/the-role-of-endoscopic-ultrasound-in-children-with-pancreatobiliary-and-gastrointestinal-disorders-a-single-center-series-and-review-of-the-literature
#3
Alessandro Fugazza, Barbara Bizzarri, Federica Gaiani, Marco Manfredi, Alessia Ghiselli, Pellegrino Crafa, Maria Clotilde Carra, Nicola de'Angelis, Gian Luigi de'Angelis
BACKGROUND: The role of endoscopic ultrasound (EUS) in the management of pancreatobiliary and digestive diseases is well established in adults, but it remains limited in children. The aim of this study was to evaluate the feasibility, safety, and clinical impact of EUS use in children. METHODS: This is a retrospective analysis of a prospectively acquired database of consecutive pediatric (< 18 years) patients presenting an indication for EUS for pancreatobiliary and gastrointestinal disorders...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29210329/a-concise-evidence-based-physical-examination-for-diagnosis-of-acromioclavicular-joint-pathology-a-systematic-review
#4
Michael K Krill, Samuel Rosas, KiHyun Kwon, Andrew Dakkak, Benedict U Nwachukwu, Frank McCormick
OBJECTIVES: The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular joint (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. METHODS: A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology...
December 6, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29208343/single-center-experience-with-intrathecal-administration-of-nusinersen-in-children-with-spinal-muscular-atrophy-type-1
#5
Astrid Pechmann, Thorsten Langer, Sabine Wider, Janbernd Kirschner
BACKGROUND: Spinal muscular atrophy (SMA) is a neuromuscular disorder mainly characterized by proximal muscle weakness. There have been enormous advances in therapeutic development with the possibility to influence the clinical course of the disease. Nusinersen is the first approved drug to treat SMA. It is administered intrathecally and acts as splicing modifier of the SMN2 gene. METHODS: Lumbar punctures were performed using a standardized protocol. To evaluate safety and feasibility of the intrathecal treatment, vital signs and the need for sedation, analgesia or mechanical ventilation during the procedure were monitored...
November 21, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29207857/diagnosis-and-management-of-rectal-neuroendocrine-tumors
#6
REVIEW
Shreya Chablaney, Zachary A Zator, Nikhil A Kumta
The incidence of rectal neuroendocrine tumors (NETs) has increased by almost ten-fold over the past 30 years. There has been a heightened awareness of the malignant potential of rectal NETs. Fortunately, many rectal NETs are discovered at earlier stages due to colon cancer screening programs. Endoscopic ultrasound is useful in assessing both residual tumor burden after retrospective diagnosis and tumor characteristics to help guide subsequent management. Current guidelines suggest endoscopic resection of rectal NETs ≤10 mm as a safe therapeutic option given their low risk of metastasis...
November 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29205374/ethyl-chloride-spray-for-musculoskeletal-ultrasound-guided-injections-an-alternative-to-subcutaneous-injection-of-local-anesthetic-solution
#7
Amit Shah, Alessandro Vidoni, Sharon McGarry, Mark Davies, Steven James, Rajesh Botchu
Ultrasound-guided injections such as steroid injections are common procedures involving the musculoskeletal system. They are usually performed after a subcutaneous injection of local anesthetic (LA), which can be painful. In 126 consecutive patients, local anesthesia was performed using ethyl chloride spray prior to a therapeutic ultrasound-guided injection in joints, tendons, or bursae. Ninety-nine (78.5%) patients found the use of ethyl chloride spray helpful. The use of ethyl chloride spray is an effective, patient-friendly alternative to the standard injection of local aesthetic for ultrasound-guided therapeutic musculoskeletal injections with the advantage of a lower cost of $0...
December 4, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29204925/ultrasound-based-triggered-drug-delivery-to-tumors
#8
REVIEW
Ankit Jain, Ankita Tiwari, Amit Verma, Sanjay K Jain
Over the past few decades, applications of ultrasound (US) in drug delivery have been documented widely for local and site-specific release of bioactives in a controlled manner, after acceptable use in mild physical therapy for tendinitis and bursitis, and for high-energy applications in fibroid ablation, cataract removal, bone fracture healing, etc. US is a non-invasive, efficient, targetable and controllable technique. Drug delivery can be enhanced by applying directed US in terms of targeting and intracellular uptake...
December 4, 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/29204677/the-predictive-value-of-quantitative-dce-metrics-for-immediate-therapeutic-response-of-high-intensity-focused-ultrasound-ablation-hifu-of-symptomatic-uterine-fibroids
#9
Chao Wei, Xin Fang, Chuan-Bin Wang, Yu Chen, Xiao Xu, Jiang-Ning Dong
PURPOSE: The aim of this study was to investigate the value of quantitative DCE-MRI parameters for predicting the immediate non-perfused volume ratio (NPVR) of HIFU therapy in the treatment of symptomatic uterine fibroids. MATERIALS AND METHODS: A total of 78 symptomatic uterine fibroids in 65 female patients were treated with US-HIFU therapy. All patients underwent conventional MRI and DCE-MRI scans 1 day before and 3 days after HIFU treatment. Permeability parameters K trans, K ep, V e, and V p and T1 perfusion parameters BF and BV of pretreatment were measured as a baseline, while NPVR was used to assess immediate ablation efficiency...
December 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29204338/giant-left-atrium-encountered-during-right-sided-thoracentesis
#10
Rashmi Advani, Benjamin T Galen
Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29203040/-management-of-traumatic-and-iatrogenic-arterial-pseudoaneurysms-in-a-tropical-environment
#11
F Raherinantenaina, R A L Rakotorahalahy, M C G Andrianandraina, H N Rakoto Ratsimba, T M A Rajaonanahary
A false aneurysm or pseudoaneurysm (PA) is the formation of a pulsatile and encapsulated hematoma in communication with the lumen of a perforated artery. Its origin is different but most cases are associated with a traumatic event. Currently, the referenced treatment is endovascular surgery but it is not feasible for the majority of vascular surgeons working in a tropical environment. The aim of this study was to describe the diagnostic and therapeutic aspects of arterial PA (APA) encountered in our institution and to evaluate the place of open surgical technique in their management...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29201485/retroperitoneal-ectopic-pregnancy-diagnosis-and-therapeutic-challenges
#12
Salma Ouassour, Abdelhai Adib Filali, Mohamed Raiss, Rachid Bezad, Zakia Tazi, Mohamed Hassan Alami, Jihane Bennani, Rachida Dafiri
Background: Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report: We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29199604/mirna-a-diagnostic-and-therapeutic-tool-for-pancreatic-cancer
#13
Muhammad Imran Qadir, Arooj Faheem
Pancreatic ductal adenocarcinoma (PDAC) is fatal disease and one of the major causes of death among cancer patients. Diagnosis of PDAC during the early stages of cancer using ultrasounds and blood tests is difficult and chemotherapies alone for treating cancers are not very effective. MicroRNAs (miRNAs), small non-coding RNAs that alter the expression of genes in many processes, have been identified to play a significant role in pancreatic cancer regulation. miRNAs are classified as oncomiRs (tumor inducers) and tumor suppressor miRNAs...
2017: Critical Reviews in Eukaryotic Gene Expression
https://www.readbyqxmd.com/read/29196306/perinatal-infratentorial-haemorrhage-a-rare-but-possibly-life-threatening-condition
#14
Bettina Cornelia Henzi, Bendicht Wagner, Rajeev Kumar Verma, Sandra Bigi
BACKGROUND: Perinatal infratentorial haemorrhage (PIH) is a rare birth complication associated with abnormal labour. CASE PRESENTATION: A baby boy was born by vacuum extraction at 41 weeks' gestational age. The pregnancy was uneventful and Apgar scores were 3/6/9. Following initial resuscitation, insufficient and irregular breathing, non-reactive pupils and absence of spontaneous movements were noted. A diagnosis of perinatal asphyxia with hypoxic-ischaemic encephalopathy (HIE) was considered...
December 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29195473/clustering-dynamics-of-microbubbles-exposed-to-low-pressure-1-mhz-ultrasound
#15
Carole Lazarus, Antonios N Pouliopoulos, Marc Tinguely, Valeria Garbin, James J Choi
Ultrasound-driven microbubbles have been used in therapeutic applications to deliver drugs across capillaries and into cells or to dissolve blood clots. Yet the performance and safety of these applications have been difficult to control. Microbubbles exposed to ultrasound not only volumetrically oscillate, but also move due to acoustic radiation, or Bjerknes, forces. The purpose of this work was to understand the extent to which microbubbles moved and clustered due to secondary Bjerknes forces. A microbubble population was exposed to a 1-MHz ultrasound pulse with a peak-rarefactional pressure of 50-100 kPa and a pulse length of 20 ms...
November 2017: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/29193279/numerical-and-experimental-evaluation-of-high-intensity-focused-ultrasound-induced-lesions-in-liver-tissue-ex-vivo
#16
Samaneh Haddadi, Mohammad Taghi Ahmadian
OBJECTIVES: Recent advances in the field of acoustics and piezoelectric and ultrasound transducers have led to new approaches to the diagnosis and treatment of certain diseases. One method of treatment with ultrasonic waves is high-intensity focused ultrasound (HIFU) treatment, which is a thermal therapeutic method used to treat malignant tumors. Although a variety of treatment-planning strategies using ultrasonic waves have been investigated, little clinical success has been achieved...
November 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29192422/executive-summary-on-the-use-of-ultrasound-in-the-critically-ill-consensus-report-from-the-3rd-course-on-acute-care-ultrasound-cacu
#17
Manu L N G Malbrain, Brecht De Tavernier, Sandrine Haverals, Michel Slama, Antoine Vieillard-Baron, Adrian Wong, Jan Poelaert, Xavier Monnet, Willem Stockman, Paul Elbers, Daniel Lichtenstein
Over the past decades, ultrasound (US) has gained its place in the armamentarium of monitoring tools in the intensive care unit (ICU). Critical care ultrasonography (CCUS) is the combination of general CCUS (lung and pleural, abdominal, vascular) and CC echocardiography, allowing prompt assessment and diagnosis in combination with vascular access and therapeutic intervention. This review summarises the findings, challenges lessons from the 3rd Course on Acute Care Ultrasound (CACU) held in November 2015, Antwerp, Belgium...
December 1, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29192421/the-state-of-critical-care-ultrasound-training-in-europe-a-survey-of-trainers-and-a-comparison-of-available-accreditation-programmes
#18
Laura Galarza, Adrian Wong, Manu L N G Malbrain
BACKGROUND: Although critical care ultrasound (CCUS) in the Intensive Care Unit has been increasing exponentially for diagnostic and therapeutic purposes, the lack of a uniform formal training structure and programme has posed the question of whether scans have been appropriately performed or reported, and whether there exists proper clinical governance to ensure a high standard of care. METHODS: An online survey was sent to the representatives of various national intensive care societies via the European Society of Intensive Care Medicine CoBaTrICE committee...
December 1, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29192346/in-vitro-sonothrombolysis-enhancement-by-transiently-stable-microbubbles-produced-by-a-flow-focusing-microfluidic-device
#19
Adam J Dixon, John Marschner Robert Rickel, Brian D Shin, Alexander L Klibanov, John A Hossack
Therapeutic approaches that enhance thrombolysis by combining recombinant tissue plasminogen activator (rtPA), ultrasound, and/or microbubbles (MBs) are known as sonothrombolysis techniques. To date, sonothrombolysis approaches have primarily utilized commercially available MB formulations (or derivatives thereof) with diameters in the range 1-4 µm and circulation lifetimes between 5 and 15 min. The present study evaluated the in vitro sonothrombolysis efficacy of large diameter MBs (d MB ≥ 10 µm) with much shorter lifetimes that were produced on demand and in close proximity to the blood clot using a flow-focusing microfluidic device...
November 30, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29191926/molecular-ultrasound-imaging-of-junctional-adhesion-molecule-a-depicts-acute-alterations-in-blood-flow-and-early-endothelial-dysregulation
#20
Adelina Curaj, Zhuojun Wu, Anne Rix, Oliver Gresch, Marieke Sternkopf, Setareh Alampour-Rajabi, Twan Lammers, Marc van Zandvoort, Christian Weber, Rory R Koenen, Elisa A Liehn, Fabian Kiessling
OBJECTIVE: The junctional adhesion molecule A (JAM-A) is physiologically located in interendothelial tight junctions and focally redistributes to the luminal surface of blood vessels under abnormal shear and flow conditions accompanying atherosclerotic lesion development. Therefore, JAM-A was evaluated as a target for molecularly targeted ultrasound imaging of transient endothelial dysfunction under acute blood flow variations. APPROACH AND RESULTS: Flow-dependent endothelial dysfunction was induced in apolipoprotein E-deficient mice (n=43) by carotid partial ligation...
November 30, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
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